Mouth breathing and its influence on facial and tooth development
Breath to humans is as similar in necessity as sunlight to a tree. But, if a tree receives sunlight from only one direction, the trunk and branches grow toward the light source, and the tree will become permanently deformed. If a child is unable to maintain a consistent, healthy nasal airway, the body will automatically program the system 
to take breaths through the mouth. Whenever a child cannot breathe through the nose, a mouth-breathing mode of respiration occurs. One cause of nasal airway obstruction in the child is allergic rhinitis, where the nasal mucosa swells and blocks the flow of air. Most allergic responses are initiated by airborne particles, smoke, foods and sometimes pet dander. The adenoids and tonsils get enlarged in response to infection of the nose and sinuses thus further obstructing the nasal airway.
Other causes of reduced nasal respiration include asthma, nasal polyps, deviated nasal septa, unreduced fractures and congenital nasal deformities. Treatment of nasal airway obstruction and mouth breathing should involve a multidiscipline approach. The orthodontist is uniquely qualified to monitor and modify the growing face and may often be in the middle of a referral pattern involving ear, nose and throat doctors, allergists, pediatricians and other health care professionals.
The adaptation from nasal to mouth breathing allows a number of unhealthy things to happen.
- Chronic middle ear infections
- Sinusitis
- Upper airway infections
- Decrease in oxygen intake into the lungs, which can lead to a lack of energy
- Abnormal swallowing pattern
In adapting the mouth for breathing, two basic changes take place; the upper lip is raised and the lower jaw is maintained in an open posture. The tongue, which is normally placed near the roof of the mouth, drops to the floor of the mouth and protrudes to allow a greater volume of air into the back of the throat. This alters the normal muscular activity of the face and jaw during critical developing years and modifies the growth pattern of the face and mouth.
The largest increments of growth occur during the earliest years of life. By age four, the facial skeleton has reached 60% of its adult size, and by age 12, when most parents’ think of orthodontic treatment, 90% of facial growth has already occurred. Consequently, if a child has chronic untreated nasal obstruction during the early critical growing years, facial deformities result… some subtle, some more noticeable.
Dr. Bhatia recommends a child’s first visit to the family or pediatric Dentist at age 2 and an Orthodontic screening between 7 and 9 years of age. Parents should be keenly aware that care of the developing face begins at birth; and any nasal airway problems should be addressed as soon as they are noticed. When parents take early orthodontic action, not only can the existing problems be corrected, but also the physical and emotional pain the child may experience can be prevented. We CAN help influence proper facial growth and maximize quality of life for a child. How your children breathe should not be taken for granted.
Dr. Bhatia has completed 2 full years of specialty training in Orthodontics after obtaining her degrees in Pediatric Dentistry and General Dentistry. She maintains a practice in Advanced Orthodontics in her offices in Kihei and Lahaina.
